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Association between sugammadex and anaphylaxis in pediatric patients: A nested case‐control study using a national inpatient database
Author(s) -
Tadokoro Fumino,
Morita Kojiro,
Michihata Nobuaki,
Fushimi Kiyohide,
Yasunaga Hideo
Publication year - 2018
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/pan.13401
Subject(s) - medicine , sugammadex , anaphylaxis , odds ratio , perioperative , anesthesia , confidence interval , retrospective cohort study , rocuronium , surgery , allergy , immunology , intubation
Summary Background Sugammadex is used as a reversal drug during anesthesia. Although several case reports have described anaphylaxis following sugammadex infusion, little is known about the relationship between sugammadex and anaphylaxis, particularly in pediatric patients. Aims The aim of this retrospective study was to investigate the association between sugammadex and in‐hospital anaphylaxis in pediatric patients who underwent general anesthesia. Methods We identified patients who underwent general anesthesia in a Japanese national inpatient database between July 2010 and March 2016. We conducted 1‐4 case‐control matching between patients with and without perioperative anaphylaxis. We calculated the adjusted odds ratio for sugammadex use and occurrence of anaphylaxis, using a conditional logistic regression analysis with adjustment for duration of anesthesia, antibiotics, and blood transfusions. Results Among 835 405 patients who underwent general anesthesia, we identified 149 (0.018%) patients with anaphylactic shock and 472 (0.056%) with a combination of anaphylaxis associated signs/symptoms and skin lesions. Sugammadex use was not significantly associated with anaphylactic shock (odds ratio, 0.80; 95% confidence interval, 0.53‐1.21; P = .29) or the combination of anaphylaxis associated signs/symptoms and skin lesions (odds ratio, 1.25; 95% confidence interval, 0.97‐1.60; P = .08). Conclusion The present study showed no significant association between sugammadex and perioperative anaphylaxis in pediatric patients who underwent general anesthesia.

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